Propofol Disposal in the Operating Room: Addressing the Practice Knowledge Gap

Background: There is an increasing incidence of propofol diversion and abuse amongst healthcare workers. Barnes Jewish Hospital (BJH) has implemented the Stericycle controlled substance disposal system (CsRx) in the operating rooms (ORs) to address this issue; however, propofol continued to be left unsecured. Purpose: The QI initiative aimed to raise anesthesia clinician awareness of propofol’s abuse potential and of the Stericycle CsRx container, ultimately to reduce unsecured propofol. Methods: An educational intervention was utilized to address the identified problem. Data on unsecured propofol was collected via an auditing process of pharmaceutical waste bin contents at the BJH North campus endoscopy suite. Data on anesthesia clinicians’ knowledge and attitudes related to propofol disposal and diversion was collected via a survey tool. Implementation Procedure: Baseline data was collected via four auditing sessions, over a two-week period, and via the survey tool. Data collection then occurred at one-, two-, and four-weeks post-education to assess for anticipated project outcomes. Implications/Conclusion: Post-education, respondents had a greater appreciation for the dangers of unsecured propofol and greater support for the effectiveness of the Stericycle CsRx container. A decrease in unsecured propofol was met at the project site, reducing diversion risk

Huskers Helping Huskers: A Corporate-Level Analysis of the Nebraska Alumni Association

The Nebraska Alumni Association appears to have become distracted from serving the alumni and has instead focused its energy into advancing University interests. To graduating Huskers, it has become unclear what value the Nebraska Alumni Association provides to them and whose interests they are promoting. This has resulted in a declining alumni membership base and an unstable revenue source. Because of this, we recommend that the Nebraska Alumni Association refocus their resources into serving alumni first

A comparison of low-dose risperidone to paroxetine in the treatment of panic attacks: a randomized, single-blind study

<p>Abstract</p> <p>Background</p> <p>Because a large proportion of patients with panic attacks receiving approved pharmacotherapy do not respond or respond poorly to medication, it is important to identify additional therapeutic strategies for the management of panic symptoms. This article describes a randomized, rater-blind study comparing low-dose risperidone to standard-of-care paroxetine for the treatment of panic attacks.</p> <p>Methods</p> <p>Fifty six subjects with a history of panic attacks were randomized to receive either risperidone or paroxetine. The subjects were then followed for eight weeks. Outcome measures included the Panic Disorder Severity Scale (PDSS), the Hamilton Anxiety Scale (Ham-A), the Hamilton Depression Rating Scale (Ham-D), the Sheehan Panic Anxiety Scale-Patient (SPAS-P), and the Clinical Global Impression scale (CGI).</p> <p>Results</p> <p>All subjects demonstrated a reduction in both the frequency and severity of panic attacks regardless of treatment received. Statistically significant improvements in rating scale scores for both groups were identified for the PDSS, the Ham-A, the Ham-D, and the CGI. There was no difference between treatment groups in the improvement in scores on the measures PDSS, Ham-A, Ham-D, and CGI. Post hoc tests suggest that subjects receiving risperidone may have a quicker clinical response than subjects receiving paroxetine.</p> <p>Conclusion</p> <p>We can identify no difference in the efficacy of paroxetine and low-dose risperidone in the treatment of panic attacks. Low-dose risperidone appears to be tolerated equally well as paroxetine. Low-dose risperidone may be an effective treatment for anxiety disorders in which panic attacks are a significant component.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov Identifier: NCT100457106</p

Genetic variants associated with subjective well-being, depressive symptoms, and neuroticism identified through genome-wide analyses

Very few genetic variants have been associated with depression and neuroticism, likely because of limitations on sample size in previous studies. Subjective well-being, a phenotype that is genetically correlated with both of these traits, has not yet been studied with genome-wide data. We conducted genome-wide association studies of three phenotypes: subjective well-being (n = 298,420), depressive symptoms (n = 161,460), and neuroticism (n = 170,911). We identify 3 variants associated with subjective well-being, 2 variants associated with depressive symptoms, and 11 variants associated with neuroticism, including 2 inversion polymorphisms. The two loci associated with depressive symptoms replicate in an independent depression sample. Joint analyses that exploit the high genetic correlations between the phenotypes (|ρ^| ≈ 0.8) strengthen the overall credibility of the findings and allow us to identify additional variants. Across our phenotypes, loci regulating expression in central nervous system and adrenal or pancreas tissues are strongly enriched for association.</p

Evidence for a retroviral insertion in TRPM1 as the cause of congenital stationary night blindness and leopard complex spotting in the horse

Leopard complex spotting is a group of white spotting patterns in horses caused by an incompletely dominant gene (LP) where homozygotes (LP/LP) are also affected with congenital stationary night blindness. Previous studies implicated Transient Receptor Potential Cation Channel, Subfamily M, Member 1 (TRPM1) as the best candidate gene for both CSNB and LP. RNA-Seq data pinpointed a 1378 bp insertion in intron 1 of TRPM1 as the potential cause. This insertion, a long terminal repeat (LTR) of an endogenous retrovirus, was completely associated with LP, testing 511 horses (χ²=1022.00, p<<0.0005), and CSNB, testing 43 horses (χ2=43, p<<0.0005). The LTR was shown to disrupt TRPM1 transcription by premature poly-adenylation. Furthermore, while deleterious transposable element insertions should be quickly selected against the identification of this insertion in three ancient DNA samples suggests it has been maintained in the horse gene pool for at least 17,000 years. This study represents the first description of an LTR insertion being associated with both a pigmentation phenotype and an eye disorder.Rebecca R. Bellone … David L. Adelson, Sim Lin Lim … et al

Fighting the "Big Lie" in the Big Easy

(Statement of Responsibility) by Samantha Conley(Thesis) Thesis (B.A.) -- New College of Florida, 2007(Electronic Access) RESTRICTED TO NCF STUDENTS, STAFF, FACULTY, AND ON-CAMPUS USE(Bibliography) Includes bibliographical references.(Source of Description) This bibliographic record is available under the Creative Commons CC0 public domain dedication. The New College of Florida, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.(Local) Faculty Sponsor: Hernandez, Sara

Huskers Helping Huskers: A Corporate-Level Analysis of the Nebraska Alumni Association

The Nebraska Alumni Association appears to have become distracted from serving the alumni and has instead focused its energy into advancing University interests. To graduating Huskers, it has become unclear what value the Nebraska Alumni Association provides to them and whose interests they are promoting. This has resulted in a declining alumni membership base and an unstable revenue source. Because of this, we recommend that the Nebraska Alumni Association refocus their resources into serving alumni first

Identification of genetic variants associated with dengue or West Nile virus disease: a systematic review and meta-analysis

Abstract Background Dengue and West Nile viruses are highly cross-reactive and have numerous parallels in geography, potential vector host (Aedes family of mosquitoes), and initial symptoms of infection. While the vast majority (> 80%) of both dengue and West Nile virus infections result in asymptomatic infections, a minority of individuals experience symptomatic infection and an even smaller proportion develop severe disease. The mechanisms by which these infections lead to severe disease in a subset of infected individuals is incompletely understood, but individual host differences including genetic factors and immune responses have been proposed. We sought to identify genetic risk factors that are associated with more severe disease outcomes for both viruses in order to shed light on possible shared mechanisms of resistance and potential therapeutic interventions. Methods We applied a search strategy using four major databases (Medline, PubMed, Embase, and Global Health) to find all known genetic associations identified to date with dengue or West Nile virus disease. Here we present a review of our findings and a meta-analysis of genetic variants identified. Results We found genetic variations that are significantly associated with infections of these viruses. In particular we found variation within the OAS1 (meta-OR = 0.83, 95% CI: 0.69–1.00) and CCR5 (meta-OR = 1.29, 95% CI: 1.08–1.53) genes is significantly associated with West Nile virus disease, while variation within MICB (meta-OR = 2.35, 95% CI: 1.68–3.29), PLCE1 (meta-OR = 0.55, 95% CI: 0.42–0.71), MBL2 (meta-OR = 1.54, 95% CI: 1.02–2.31), and IFN-γ (meta-OR = 2.48, 95% CI: 1.30–4.71), is associated with dengue disease. Conclusions Despite substantial heterogeneity in populations studied, genes examined, and methodology, significant associations with genetic variants were found across studies within both diseases. These gene associations suggest a key role for immune mechanisms in susceptibility to severe disease. Further research is needed to elucidate the role of these genes in disease pathogenesis and may reveal additional genetic factors associated with disease severity

Additional file 3: of Identification of genetic variants associated with dengue or West Nile virus disease: a systematic review and meta-analysis

Included Papers. All publications included in this review are listed, with study details on authors, year of publication, country, sample size, case and control group definitions, and genotyping method. (XLSX 54 kb